Treatment of Molluscum Contagiosum in Children with Imiquimod 5% Cream: An Open-Label Study Using Th
Journal of Pan-Arab League of Dermatologists
Vol. 19, No. 2, June 2008 Page 43- 52
Treatment of Molluscum Contagiosum in Children with Imiquimod 5%Cream: An Open-Label Study Using Three Different Dose Regimens
El-Shahat F Ahmed, Mamdouh M Abdel Gawad, Mohammed F El-Kamel, Moustafa A El-Saied
Departments of Dermatology, Andrology & STDs, Mansoura University, Egypt
Abstract
Background: There is a wide variety of topicalor surgical treatment options for molluscumcontagiosum (MC). However, treatment inyoung or anxious children isdifficult, timeconsumingand often painful. Imiquimod, atopical immune response modifier, has beenused for the treatment of molluscum contagiosumusing differentdose regimens with variableresults.
Objective: The objective of this study was toevaluate the clinical efficacy and safety of 5%imiquimod cream in treating molluscum contagiosuminimmunocompetent children usingthree different dose regimens.Methods: Fifty four children ranging in agefrom 2 to 10 years with multiple molluscum contagiosumwere enrolled in this open-label, follow-up study. Patients were randomized intothree equal, dose-frequency treatment groups(18 patients in each group).Imiquimod 5%cream was applied once daily each night of theweek in the first group, once daily 5 consecutivenights per week in the second group , and oncedaily three times per week (every other day) inthe last group. Assessment for response and theoccurrence of side effects was performed every2 weeks untilclinical cure or up to a maximumof 16 weeks. Local skin reactions, partial andcomplete clearances, and lesion counts werestatistically analyzed.
Results: Fifty one children completed the study.Complete response rates were 66% (12/18),64.7% (11/17), and 25% (4/16) for patients inthe first group(7×/wk), the second group(5×/wk), and the third group (3×/wk), respectively.The percentage of patients who werecompletely cleared was nearly similar in firstand second groups, but was significantly highercompared with the third group. In general, thetreatment was well-tolerated, without systemicside-effects. Thecommonest local side-effectsincluded erythema, tenderness, itching, burningsensations, and pain with no significant differencesbetween the three groups.
Conclusion: Imiquimod 5% cream was effectiveand safe in a good percentage of patients withMC. Daily or 5 times a week dosing for 16weeks demonstratedsimilar efficacy and safetyprofiles. However, 5 times per week dosing is
more cost-effective.
Journal of Pan-Arab League of Dermatologists
Vol. 19, No. 2, June 2008 Page 43- 52
Treatment of Molluscum Contagiosum in Children with Imiquimod 5%Cream: An Open-Label Study Using Three Different Dose Regimens
El-Shahat F Ahmed, Mamdouh M Abdel Gawad, Mohammed F El-Kamel, Moustafa A El-Saied
Departments of Dermatology, Andrology & STDs, Mansoura University, Egypt
Abstract
Background: There is a wide variety of topicalor surgical treatment options for molluscumcontagiosum (MC). However, treatment inyoung or anxious children isdifficult, timeconsumingand often painful. Imiquimod, atopical immune response modifier, has beenused for the treatment of molluscum contagiosumusing differentdose regimens with variableresults.
Objective: The objective of this study was toevaluate the clinical efficacy and safety of 5%imiquimod cream in treating molluscum contagiosuminimmunocompetent children usingthree different dose regimens.Methods: Fifty four children ranging in agefrom 2 to 10 years with multiple molluscum contagiosumwere enrolled in this open-label, follow-up study. Patients were randomized intothree equal, dose-frequency treatment groups(18 patients in each group).Imiquimod 5%cream was applied once daily each night of theweek in the first group, once daily 5 consecutivenights per week in the second group , and oncedaily three times per week (every other day) inthe last group. Assessment for response and theoccurrence of side effects was performed every2 weeks untilclinical cure or up to a maximumof 16 weeks. Local skin reactions, partial andcomplete clearances, and lesion counts werestatistically analyzed.
Results: Fifty one children completed the study.Complete response rates were 66% (12/18),64.7% (11/17), and 25% (4/16) for patients inthe first group(7×/wk), the second group(5×/wk), and the third group (3×/wk), respectively.The percentage of patients who werecompletely cleared was nearly similar in firstand second groups, but was significantly highercompared with the third group. In general, thetreatment was well-tolerated, without systemicside-effects. Thecommonest local side-effectsincluded erythema, tenderness, itching, burningsensations, and pain with no significant differencesbetween the three groups.
Conclusion: Imiquimod 5% cream was effectiveand safe in a good percentage of patients withMC. Daily or 5 times a week dosing for 16weeks demonstratedsimilar efficacy and safetyprofiles. However, 5 times per week dosing is
more cost-effective.